Their Families
QUESTIONS OR CONCERNS
Age: Birth to Three Years Child appears to have difficulty relating to caregiver or does not meet typical developmental milestones or demon-strate age-appropriate behavior.
Child care providers can:
• Observe the child and provide developmental information to the parent.
• Share information regarding the child’s interests, interactions, and behaviors at home and in the child care setting.
• Work closely with families to iden-tify specific areas of concern.
• Refer to a medical provider to rule out any physical causes, including vision and hearing problems.
• Discuss with the family the option to refer their child to the California Early Start Program. Call the Babyline at 800-515-BABY for information and referral sources.
• Call the California Child Care Healthline at 800-333-3212 for more information.
REFERRAL
Children from birth to three years may qualify for early intervention services in the Early Start Program.
The parents may refer their child di-rectly to an Early Start Program or have their health care provider or other pro-fessional make the referral. Parents do not have to make that first call. After the referral, the parents will be contacted, informed of their rights as parents un-der the law, and asked whether they wish to initiate services. A service coor-dinator will be assigned to assist the family.
Parents have the right to an evaluation of their child’s performance. Referrals should be made to the local regional center or school district. Call the Depart-ment of DevelopDepart-mental Services at 800-515-2229 to obtain the phone numbers in your area.
EVALUATION AND ASSESSMENT
Evaluation may determine whether the child has a delay or disability; identify the child’s strengths and concerns about development; and help in planning for intervention.
Children referred to the Early Start Pro-gram are evaluated by means that are not racially or culturally discriminatory.
Evaluation is conducted in the following developmental areas: physical (includes vision, hearing, and health status), cogni-tive, communication, social or emotional, and adaptive skills.
Evaluation and assessment:
• Are conducted by a multidisciplinary team of qualified personnel that consists of a nurse, a psychologist, an educator, or therapists.
• Identify the infant or toddler’s unique strengths and needs.
• With family consent, identify family resources, priorities, and concerns in the language of the parents’ choice.
• Must be completed within 45 days of referral.
• Should be ongoing as the child develops and grows.
Many families and child care providers have questions about children·s development. Although many resources are available to both families and providers, trying to navigate and understand the system for delivering services can be confusing and overwhelming. Both legal and practical information is provided to help you. This chart has been developed and reviewed by parents, providers, and professionals to help other parents understand the system for delivering services to children with special needs. Please call the California Child Care Healthline at 800-333-3212 if you have questions or comments about the information or have a concern about your child.
ELIGIBILITY
Eligibility for services is based on the results of the evaluation and includes one or more of the following conditions:
1. Significant delays in one or more of the following developmental areas:
cognitive; physical and motor, including vision and hearing; communication;
social or emotional; or adaptive (self-help) 2. “Established risk
condi-tions,” which means having a high probability of leading to developmental delay (e.g., Down syndrome) 3. High risk of having a
developmental disability due to a combination of biomedical risk factors (e.g., low birth weight, prematurity, or medical complications)
For children who do not qualify for services, a meeting is held to discuss the evaluation results.
Families and providers may make specific suggestions for working with the child. The child care provider may attend the meeting if the parent so requests.
PROGRAM PLANNING
Individualized family service plans (IFSPs) are developed for infants and toddlers who qualify for the Early Start Program and include the following information:
• Child’s present level of development
• If the family consents, the resources, priorities, and concerns of the family
• Major outcomes desired for the child/family
• Specific early interven-tion and other appropri-ate services necessary
• Dates for initiation and duration of services
• Planning for the child’s transition at age three to a preschool program or other community services
• Informed written consent of parents or guardian Child care providers may attend IFSP meetings if the parent requests their pres-ence.
The IFSP meeting is con-ducted in the language of the family or through the use of interpreters.
SERVICES
A variety of services may be offered to promote the child’s development and support the family.
Services are provided in natural environments, such as:
• The child’s home
• The child care center and/or family child care homes
• Other settings where there are typically devel-oping children
A listing of services for chil-dren who are eligible can be found on page 18.
TRANSITION OR PERIODIC REVIEW
The IFSP must be reviewed every six months or as needed or requested.
The Early Start Program ends when the child turns three. A transition plan to preschool is written as part of the IFSP when the child is two years, nine months (or earlier if needed) to prepare for the change in program.
The service coordinator facili-tates the transition and the exchange of information be-tween regional centers, schools, and other agencies.
Transition steps may include:
• Obtaining parental consent for a referral to the school district for special educa-tion services
• Obtaining parental consent for referrals to other community agencies
• Arranging for evaluations to determine eligibility for special education services at age three
• Developing an individual-ized education program (IEP) to be implemented by age three
At the request of parents, child care providers may give recommendations for the transition process, informa-tion to preschool programs, and support to families.
Map to Services (Continued)
QUESTIONS OR CONCERNS
Age: Three to Five Years Child is having difficulty at home or in child care and is not developing as are other children of the same age.
Child care providers can:
Use the brochure Reasons for Concern as a guide. Concerns for preschool chil-dren may include the following signs.
The child—
• Has limited understanding and use of language
• Does not play with other children
• Has a very short attention span
• Is overly aggressive or frequently hurts self or others
• Falls frequently, is clumsy, has poor motor coordination Discuss parents’ perception of the child’s strengths and any concerns.
Have parents observe their child in the child care program.
Maintain open and ongoing communi-cation with the family and school.
REFERRAL
Parents should call the local school district or county office of education to make a referral. Other agencies and child care programs may contact the school, but only with the written con-sent of the family.
• The family should contact the regional center (call 800-515-BABY for the local contact) if a develop-mental disability is suspected.
Regional centers have 15 working days to complete the intake process.
• A referral to the health care pro-vider should be made to rule out physical or health causes.
EVALUATION AND ASSESSMENT
School districts evaluate children to determine whether they qualify for spe-cial education and related services. Writ-ten parental permission is required for the evaluation.
Health care and other professionals should stay informed and involved.
Information from child care staff may be included as part of the assessment.
Assessment:
• Must be done in the primary lan-guage of the child by a team of professionals.
• May be conducted in group care settings, including child care.
• Should be unbiased.
• Should be completed in all areas of the suspected disability.
Parents have the right to request an as-sessment of their child for eligibility with the regional center if a disability is present. There are legal timelines to the process. For information regarding all parental rights and entitled services in the regional center system, call Protec-tion & Advocacy, Inc., at 800-776-5746.
Map to Services (Continued)
ELIGIBILITY
To qualify for special education services, children three to five years of age must meet one of the following criteria:
1. The child has a significant delay in one of the following skill areas: gross or fine motor development, recep-tive or expressive language, social or emotional ment, cognitive ment, or visual develop-ment.
2. The child has a moderate delay in any two areas noted above.
3. The child has a disabling condition or established medical disability that can include autism, trau-matic brain injury, or visual impairment.
PROGRAM PLANNING
Individualized education programs (IEPs) are devel-oped for children who qualify for special education and contain the following information:
• Present levels of educa-tional performance
• Measurable annual goals and short-term objectives
• Services related to special education
• Supplementary aids and services and program modifications or supports provided for school personnel
• Explanation of why the child will not participate in the regular class
• Individual modifications needed to participate in state and districtwide assessments
• Projected dates to begin services and the fre-quency, location, and duration; dates of modifi-cations
• How the child’s progress is measured and how parents will be regularly informed
School districts develop a
“504 Plan” for children with a disability who require adaptation or services but do not qualify for special educa-tion. This can be used for children with health prob-lems (e.g., asthma, diabetes, seizures) and attention defi-cit disorder.
Regional centers develop an individualized program plan (IPP) for children who qualify for their services.
SERVICES
Services are provided in the least restrictive environ-ment, as decided by the IEP team, which may include the home, preschool, or child care setting.
A listing of preschool special education services for chil-dren who qualify may be found on page 18.
Regional center services are based on the child/family needs as identified on the IPP. The services are listed on page 18.
Child care providers may invite special education and other specialist staff to ob-serve the child in your pro-gram, show you what to do, and give you information on how to best improve the child’s skills and meet his/
her needs. The specialists can also learn by seeing the child in a “typical” setting with “typical” children.
TRANSITION OR PERIODIC REVIEW
An appropriate reassess-ment should be conducted before the child enters kin-dergarten to determine whether she or he still needs special education and to plan for the appropriate services and supports.
Families should visit sites and determine the best pro-gram based on the child’s strengths and family con-cerns.
Child care providers help families by:
• Providing support
• Preparing the child/
family for change
• Accompanying the parent on site visits
• Talking with staff of special education and other programs regard-ing the child’s strengths and needs
A
ll children develop at different rates and in different ways.Some children are born with special needs that can affect their growth and development. Other children may not show developmental problems, delays, or differences until later in childhood. Fortunately, many of these children can get the support they need to reach their potential if parents and child care providers recognize the signs of need early and get help.
The Early Warning Signs described on these pages are only a few of the indicators that a child may need further observation and assessment. If, for any reason, you suspect that your child or a child in your care may have special needs, we urge you to seek help immediately. The period from birth to age three is the best time to help the child and you may prevent more serious problems from occurring later.
DON’T WAITuntil the child enters kindergarten before you ask for assistance!
Risk Factors
The following situations place children at greater risk for health and develop-mental difficulties:
• Prematurity and/or low birth weight
• Prenatal or other exposure to drugs, alcohol, or tobacco
• Violence in the community or home
• Poor nutrition
• Family stress (for example, poverty, poor housing, homelessness, death in the family)
• Does not like having certain types of materials or clothing next to body.
• Treats other children, animals, or objects cruelly or destructively.
• Tends to break things a lot.
• Displays violent behavior (tantrums, fighting, screaming, or hitting other children) on a daily basis.
• Stares into space, rocks body, or talks to self more often than other children of the same age.
• Often bangs head against an object, floor, or wall.
• Does not recognize dangerous situations, such as walking in traffic or jumping from high places.
• Tends to be sick often; complains of headaches or stomachaches.
• Has sleeping, feeding, eating or toileting problems.
• Is overly impulsive, active, or distractible.
• Does not respond to discipline as well as children of the same age.
• Has difficulty putting thoughts, actions, and movements together.
• Does not seek approval from parent or caregiver. or throat infections or allergies.
• By four months, does not look at the source of sounds or voices or react to loud noises.
• Talks in a very loud or very soft voice.
• Seems to have difficulty responding when called from across the room, even when it is for something interesting.
• Turns body so that the same ear is always turned toward a sound.
• Breathes through mouth.
• Has difficulty understanding what is said.
General Behavior
Some behaviors may be causes for concern or just part of the child’s temperament or personality. The following behaviors should be looked at in light of the whole child.
The child...
• By six months of age, avoids being held or talked to or resists being soothed and comforted.
• Does not pay attention or stay focused on an activity for as long a time as other children of the same age do.
• Avoids or rarely makes eye contact with others.
• Gets unusually frustrated when trying to do simple tasks that most children of the same age can do.
• Often acts out; appears to be very stubborn or aggressive.
• Acts extremely shy or withdrawn.
• Does not like being touched.